Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6636
Peer-review started: January 5, 2022
First decision: March 7, 2022
Revised: March 19, 2022
Accepted: May 8, 2022
Article in press: May 8, 2022
Published online: July 6, 2022
Processing time: 169 Days and 23.7 Hours
Retroperitoneal liposarcoma (RLPS) is a rare malignant tumor of the connective tissue and usually grows to a large size, undetected. Diagnosis is currently based on collective findings from clinical examinations and computed tomography (CT) and magnetic resonance imaging, the latter of which show a fat density mass and possible surrounding organ involvement. Surgical resection is the main therapeutic strategy. The efficacy and safety of further therapeutic choices, such as chemotherapy and radiotherapy, are still controversial.
A 61-year-old man presented with complaint of a large left inguinal mass that had appeared suddenly, after a slight exertion. Ultrasonography revealed an omental inguinal hernia. During further clinical examination, an enormous palpable abdominal mass, continuing from the left inguinal location, was observed. CT revealed a giant RLPS, with remarkable mass effect and wide visceral dislocation. After multidisciplinary consultation, surgical intervention was performed. Subsequent neoadjuvant chemotherapy and radiotherapy were precluded by the mass’ large size and retroperitoneal localization, features typically associated with non-response to these types of treatment. Instead, the patient underwent conservative treatment via radical surgical excision. After 1 year, his clinical condition remained good, with no radiological signs of recurrence.
Conservative treatment via surgery resulted in a successful outcome for a large RLPS.
Core Tip: Giant retroperitoneal liposarcoma (RLPS) is a rare condition. The tumor arises from retroperitoneal fatty tissue in the space between the peritoneum and posterior abdominal wall. Owing to the absence of any functional impairment for a long time, RLPS can reach large dimensions before the onset of symptoms. We report the case of a man who received a misdiagnosis of inguinal hernia and was scheduled for intervention. After a careful clinic approach and further radiological examinations, the tumor was removed by radical surgery without any damage to surrounding organs. At the 1-year follow-up no recurrence was present.